Pulmonary alveolar proteinosis and whole lung lavage in Kenya: A case report

Abstract

Pulmonary alveolar proteinosis (PAP) is a rare interstitial lung disease. The ideal therapy to clear the accumulated lipoproteinaceous material is whole lung lavage (WLL). While there have been few cases of PAP in Sub-Saharan Africa, none have been reported in Kenya. We describe a case of a 36-year-old Kenyan lady with progressive dyspnea, cough, tachypneic, and respiratory crackles at presentation. A high-resolution computed tomography (HRCT) scan showed a “crazy-paving” pattern and a transbronchial lung biopsy revealed periodic acid-Schiff positive exudates. She was diagnosed with PAP and WLL was performed. She was discharged after 3 days with marked improvement. Unfortunately, she succumbed intraoperatively during the WLL of the contralateral lung 6 weeks later and a postmortem revealed widespread proteinosis. This case illustrates the diagnosis and treatment of a rare lung disease by WLL in a resource-limited setting with the assistance of a multidisciplinary team.